CAVES Syndrome: A Newly Proposed Etiology of Acute Oculo-Auditory Inflammation

We report a novel, immune-mediated syndrome characterized by acute bilateral panuveitis, retinal vasculitis, and sensorineural hearing loss following cesarean sections complicated by major hemorrhage and intrauterine application of Chitosan-tamponade. Initially interpreted as atypical Cogan’s syndrome, three patients in their 30s presented with blurred vision, optic disc swelling, intra-/subretinal fluid, and vestibulo-auditory symptoms. However, the absence of interstitial keratitis and disease progression challenged this diagnosis. New cases from other facilities with identical clinical triggers and findings support the emergence of a distinct clinical entity, which we propose to designate CAVES (Chitosan-Associated Vasculitis with Eye and Sensorineural symptoms). A patient registry and screening protocol for gynecologic procedures involving Chitosan-tamponade has been initiated. We urge heightened clinical vigilance and call for further case reports to delineate pathophysiology and improve patient safety.